Interventional Orthopedics — Bend, OR
Interventional orthopedics is an emerging field that harnesses the power of imaging-guided injections and procedures to address issues affecting bones, soft tissues, and nerves.
Diagnostic Ultrasound
Office-based ultrasound is a powerful tool for diagnosing and treating musculoskeletal conditions that, in some cases, rivals MRI. It is radiation-free and integrated into office visits when needed for precise diagnoses.
With over a decade of experience and advanced musculoskeletal ultrasound training, HDSS physicians can incorporate this tool into patient evaluations and treatment.
Ultrasound-Guided Procedures
Ultrasound-guided injections and procedures have revolutionized how we approach the diagnosis and treatment of musculoskeletal conditions.
Using ultrasound guidance, medications or orthobiologic treatments can be delivered precisely to ensure the best response.
Percutaneous Tendon Debridement — TendoNova & Tenex
Chronic tendon pain often comes down to one problem: damaged, degenerative tissue that the body has stopped trying to repair on its own. Cortisone can quiet the inflammation temporarily. But it doesn’t address the tissue itself.
Percutaneous tendon debridement does. Using ultrasound guidance, our physicians insert a small probe through a 2–3mm opening — no open incision, no stitches — and directly remove the diseased tendon tissue. This clears the degenerative material and restarts a healing response in tissue that had effectively stalled.
At High Desert Sports & Spine, we use two systems depending on the condition and what’s clinically appropriate:
TendoNova (Ocelot System) uses a precision mechanical instrument to remove diseased tissue and, in cases involving calcific tendinitis of the rotator cuff, to break down and clear calcium deposits from the tendon. It’s well-suited for conditions where targeted mechanical debridement is the goal.
Tenex uses ultrasonic energy to disrupt and aspirate damaged tissue. The ultrasonic mechanism is particularly effective for chronic tendinopathy, where the diseased tissue is diffuse or the tendon structure is more involved.
Both are performed in the office under local anesthesia, typically in 30–45 minutes. Most patients return to light activity within a few days and progress through a structured loading program within the first week.
Conditions we commonly address with percutaneous debridement include patellar and Achilles tendinopathy, plantar fasciosis, tennis and golfer’s elbow, rotator cuff and biceps tendinopathy, gluteal tendinopathy, and select wrist and forearm conditions.
If conservative care hasn’t moved the needle on a chronic tendon problem, this is often a logical next step before considering more invasive options.
Learn more about these innovative procedures.
Ultrasound-Guided Nerve Hydrodissection
Nerve hydrodissection is a minimally invasive procedure designed to address nerve-related pain and dysfunction due to nerve entrapment.
Hydrodissection involves the careful injection of a fluid, often saline or dextrose, around a targeted nerve under ultrasound guidance.
This advanced procedure enables precise visualization of the nerve and adjacent structures in real time, ensuring accuracy and safety during the intervention.
By addressing nerve-related pain and dysfunction at its source, this procedure promotes a more focused and effective treatment.
Barbotage – Break Down Calcific Deposits Without Surgery
Calcific tendinopathy occurs when calcium deposits form within a tendon, causing pain, stiffness, and limited range of motion, most often in the rotator cuff.
Barbotage is an ultrasound-guided procedure that uses a fine needle and saline lavage to break up and aspirate those calcium deposits directly. Rather than waiting for the body to resorb them on its own, which can take months and may not fully resolve, barbotage removes the mechanical source of irritation at the tendon and triggers a fresh healing response in the surrounding tissue.
The procedure is performed in the office under local anesthesia, typically in under 45 minutes, with no need for general sedation. Most patients tolerate it well and return to light activity within a few days.
When calcific tendinopathy is confirmed on imaging and hasn’t responded to conservative care, barbotage is often one of the most direct paths to meaningful relief without surgery.
Learn more about the science behind this innovative treatment.
Ultrasound
TendoNova Ocelot System
